Parlak S, Okay AE. Urethroscrotal Fistula: A Rare Cause of Scrotal Swelling.
Pol J Radiol 2016;
81:438-40. [PMID:
27668028 PMCID:
PMC5026056 DOI:
10.12659/pjr.897937]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2015] [Accepted: 03/03/2015] [Indexed: 11/09/2022] Open
Abstract
Background
Urethroscrotal fistula (USF) is an abnormal communication between the urethra and the scrotum. This rare abnormality may be iatrogenic or secondary to perforation of the urethra by a stone. After the passage of urine to the scrotum through the fistula, painless scrotal swelling develops, which disappears completely with manual compression, and voiding can be maintained in this way. Retrograde urethrography (RU) and voiding cystourethrography (VCU) are traditional diagnostic methods, but they have limitations, such as technical difficulties and inability to evaluate the surrounding tissues. Multidetector CT (MDCT), together with reformatted images, can provide valuable information about the surrounding tissues and associated pathologies.
Case Report
We present a case of a 36-year-old male patient who had painless scrotal swelling after cystolithotomy and urethral stone surgery. The patient indicated that the swelling disappeared after manual compression. A fistula between the bulbous urethra and the scrotum was discovered by MDCT. In our case, we believe that the fistula developed iatrogenically during stone excision or secondary to perforation of the urethra by a stone.
Conclusions
As a rare pathology, urethroscrotal fistula should be considered in men with a history of urethral stone surgery and symptoms, including painless scrotal swelling, which can be manually compressed after voiding.
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